| NPI | 1326035965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME11721) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL 0011721FL) |
| 207X00000X Orthopaedic Surgery (Licence: FL 0011721) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2020-02-18 |